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HomeMy WebLinkAbout670 18TH ST - Building Permits/" � .7 - 670-zW 1IITFI- ST _- . .. �... ...' oeii:._. - - ECT�RODflE35: ""' �. � � % ' ' . � ., OWNEB'S NRME: LOI' ^C;I S : � !..'.... � - (' : � .. ; ,. i ' SAME� � - "> , ; � r aooeess: � ! . ' � , _ , ., i . .i � r )- � - . �. y S4II �G099 < , _ + • " ,. � . . .. � � �` ` � { � r � ' ' eea.xo.: . � pPCH1ENCIXEEN: � - • � ''.' ' � '_. RODflE33' ` 4 ' � , • ' i ;. � ' ' � '. : UNI7[` . .. I �i i ' �i" i .. . ' s - AMRF. , . f • . � ' . (714)'93,7-0101 . PEflMRTEE: ..,1 �i�U,. N� �Ci�}IQr 1 .. j�- ` � ' c ; " . . , R�OBESS: �' . . . .. � URANC,E • . CA 3266II' '< �.:. � . . t. " ., �.- . -. :. LICENSEO CONTMCTOB DECL,IMTION: I hereby aflirm t�at I am licensed under Drovisions of �C�aD�e� 9(commencinA ��h Section 7W0) oM1Om� ion � 1[he Business and'Prote d my license is m I farce anE ettecl. � �� Y i c, �'9"� �9"' �' '� s CITY lIC . � , �^ n STRTE LIC.: . . C - ' � � - - 2-�J '7�� � Signalure ����� � i � ' FBS' COMPEN6R71UN �ECIAMTION: I �ereby aPorm ihat 1 have a certlflczta ot consent to SelFinsure or a tetlific3te of Workers nsation1Q{�pBQ¢e, ��.4 ��P�� �@Y tnereal lSection 3800. Lab.;g)� / O 1 L 9 0 . ; .crxo.:NATL,UNION FIRE EXP.ORTE: ' , . �- . : j�COMPANY: - ' , t ' � LJ Cetlihetl coOY �s he2by /umis�eU t❑ CertiLeU coOY �5 filed vni� Ihe ciry ildmg Dinsion � �� � � . Q ,1...: ,,,���111 ..'i. . Oate: _..�—��' I D . APDlmant ���'. .. IXEMPfION FflOM WOBNEflB' fAMPEN3RTI0N OECUHIITION: Rhis secfion nee0 not 6e completeA if Ne Dermit is /or ane hunEreO (5100) ar less). I certiy t�at in the petlormance ot the work br wh¢h this Dermit is issue0. I shall nat emDloy any person in any manner m as lo becama suhle�[ to the Workers' Campensation Laws af Caldomia � , . '- , �' � . ' � ' ' � • �• • � ' '� � i Oate: i "_ '. --.� - �__ .l_ .9qnaNre" . i._. '.. . . _.i.:- ......, _... _ . � NOTICE: Ii,'atter maknA [his Eeclaration, you should 6ecome su�lect ro the Workers' Campensation provisions of tAe Labor CoOe, you must forihwiro comply with suc� pmvisians or [his parmit SAall be tleemed reJaked. ; ;, -�, , i CONSTBUCTION LEX�ING RGENCY: I��h¢re6y aifirm that there is a construction IenAing agenry fai the DeAormance of t�e work far which t�is permitis issueU (Section 3W7, Civ. C). ' ' , , � � ��� � ' � IFNUEfl: . ' t . ' ' : . -' � . , :' . � . ! < - eooaEss: � . ' . � � , ; + + . t _. - . ,.7 , - i � � ...� . � +° .y .. � .. �' � t ;' � i �: 'n�, °� � �s..':: -OWNEB BUILOEB OECUMTION: I,heieby aifrm tAat I am exempi immiAe Comroctors' State License Law for the tollovnnp reason (Secuon 7031'.5 Business antl'�Professianal Cotle: `Any city of counry whicA requires a permit to constmct, al[er, improve, Aemolish, or reDair any.sWcture, O�or to its issuance, also-requires Ne aDDlicant lor such permit lo file x siqne0 statement Itut he/s�e is IicenseO pursuant to Ihe pmvisions ol t�e Con[rador5:5tate License Law (CAaD�er.9 (commencinp wit� Sedion 7000) al 0ivision 3 af t�e Business '°rotessions Cotle�;or t�at he/she is exempt therefrom an0 Ihe basis for the alle0etl exemDtion:.Any violation ai Sec[ion 7037.5 by � �licant tor a�permit su0l�ts the zDD��cant to a civil'penalry of not more than five hunUreO tlallars (5500�. " , .. �I, as•owner af IAe pmperry;or �my employees with wages as tAeir sule(compen4atian �will, tlo ihe wark,tand the� , simcNre is nat intenUed ar ofleretl lor sale (Secbon 7044. Business'antl Pmiessional Code. The Cuniractors' Stite Licanse Law ,-�� daes no[ apply ro an owner ol a DmDerry.w�o builUs or impmves t�ereon, an0 who tloes suc� work himsell/hersell or.throup�, � �-his orher own em0loyees, pmvide0 Ihat'such imDrovements are not inten4eA ur ottered for sale. Ii, Aowever Ihe building or • imD�ovement is sold within one year of completmn ihe owner will have the 6urtlen af Drovinp he/s�e Uitl not bwltl or improve � for ihe Durpose oi sale) • . • � : , " • . , - , � ; � . � . ' �I as ownecof the pmDerty. am axclusnely coniractinp wtlh Ilcensetl conirxctors to constmct the Omle�t�(Section 70A4, Business '❑ '-'antl Profeubns Code: TOe Cantrztlors' State License Law does nat apDly to an ovmer ol Droperry wlio �mtOs or impmves Nereon anA w�o coniraqs for such D�olecis with a contractoqs) license pursuant to I�e�Caniracrors' State License Law). I,am aware � tAat Droof of t�e¢ Worker's ComDensaOon insurance�shoNd,be DronAeA to me" � . . . :� � � I am exemPt unaer Sec[ion: F .� a �• •a � a P c. "' ; � • ; , , ' fof �his reasOn. i � I. �+ . � � ' , , ,, � , r . . '� � �'. . , ' � � E ' . , � � r � Date . . � � . G . � Owner. . .. ' • . '.' 1 _ ' H alth and Safe CoOe Sections 25505 25533 anA I Eo Aereby certity tAat 1 am aware ot and un0erstanOlhe reQuirements oi Califorma e ry . 25534 an0 that I or any future builtlinq ocwpant will/will not gircle one) neetl ro comDly vnl� sai0 state cotles anG the requirements for a� permit for constmctian or'�,moAification Vom Ihe Air Qualiry ManaAement Distnct. FesiEential constmction apDlications are exempt fmm tAese pronsions. , i � � ' - � � * ; , . �� �� -� �ate � '' , ' t MPlicant ' � J . .,x . ,_ . ; � � . 1 �er¢Ey CeM1ily Ihat I have feaOlhis ap0licati0n �ana Siate �hai �he a�ov¢ inlorma0an �s mrt¢ti. I zgree �a romply wilh atl city antl COUnry 'orAinances anA state laws 2lating ta �uiltling consiructian ana here6y autAonre reD�e entatives ol iMs crry ro enter uDon the above�mentionetl pmpeM �o�inspec0on.purpases ' � � ' ' . Q% `/ t � � � Date" ��`� �'L V • SpnaNre:„ �� �� � � � ' . ; Dnver s L¢ense or Sucial Secunry M : � . � . , , 1' � .. � . . . _ tB4Ua6 "wM1lte-Builoing; oreen—Coee Enfoicement; Canary—Applicant; _ __1 .. � _ � _ _ CI.T.Y_ OF. .COSTAt, MEaA: r;•.EiUII�DZNr P1iRM2T . n---P.F.RM .NO.:._.H,-.:..�046;L 28�._._. F,E32MIT :NO Ei+ �O4'6120`v� �PLF�N CHFCK "NO ; ^+! � � =N.% + ;'+ �CnVT TN'SUPP.� iJ "� �'' ` 3 . , :� . • ,�. ,, t. .�,�i � '•�` � .. , , i j,• .1 CONSTRUCTiON TYPC . �, �'' i' ' 1 G �, PFRMIT' TYPE�:� STR : r �' � � .PTJHPOSL � ��TH � � � ! ' F � ; � t ... " � j ,; .i I y` ; � � _ � ' = i ` _ l '." ` f ' _� -JOB D�F•.SCRIF�TiGN � .• V]:NYL`SIDING . .z ' • �'' . ?`, ` SQ`FT. ,�� t�,fl00F � ` { f- c t ' 7 . I . � _ , ! � � o �' 1 • ° � ' - � � ': � � Y .� i �C (��: CIrA[M VALU� � '' 8, tS00.00i CALC-VALUC: '; `''8 f300.00 ��GRUUP GCC R 3= ��� '.�� � . ' :_ . � . : . ' � � � • r. E . . . , : . . ._.� � . r _ .' t - � . _:� � Ir. , , COMM�N'I'S: VTNYU t`�.CI`�:PNG" IC}?0�36'63 �' ' ; ' ' � � ' ' � :''" « :' • � �. a j' i , -x-*�*�*��t*x�.*��x+� �*.�**.*�-��*-�t�-x��r*+��t-x**�t***it*�+��x*�i;��*��****��**��t*�*�*�-�r�**x���+t�t-#**�,: :-e � �,'- Z`O. N I• N G,. i. R t' Q U• S=Tt ti_ M°f: N�•p>.S. . �,� � ,. „ r � ' �' � : S G,T' B A C! K'S � , i. ,�>; ' �L ' . i t' ' �,f , � ' . : . . � . � . , , . . . . . . . ' ; i ' .. .. x � . -- — -- --- MAIN- BU.iI�DING ------ --. - . -�-- -- -- ACCES;;ORY BUILTJING - .`-' ', j FRNT:. RT ;IN'REAR: `. FT ;; IN ;, ,FRNT: ET T.N RF.RR: , PT � • IN, i LEFT': ; . k;P ZN�RGHT.: ; PT � IN � 'l,L'1'T: ' E'T; IN RGHT:' 'F'T '� , I.AI' ; ' i ' .i �. � � . � . t - ' . . , . !�_ � � PI#RKING REQ: ���� � PROV: i PARC'EL: .424241?9 ZNE � ' •. �REF �NO:'�`-' , c. : j PLANNING;NOTES? � '' ' ' . � .i. � , �_ ' i "� t � ' ) . � . � . . * .� ' � . �i.' . . ' ` � • i ' t ' ff.i � 'r. *iFiE1:��(�1'dkiEjEiFkiElflE?EdE1E.1fiE'ififiEiE?EiE3E1FlE3f�IfiFiE±EiF!Ei!-,jE1f3f1flEihlFiEikfE3F?Eif3ElfiEdEfE3E�E�1E3(?FiFlE3(�1E1f��lEiE�E3E��iEiE3Eibi(iEfElF�Fifik^ "'.} � ' � D,F V E L O�P `M E N T �S E R V: I�C E S � R;E � U.I' R, .F. 'M,E Dl'-'T-S .' 4 - 9�- ZONINGi APPROVED •BY - r : i� i ' 1)A�T.E? �`'�"� � � i . . . °'-- ------ - — �--- — , , . . r . ' - i ' } � t. '. � , . . BU,ILDING � APPROV�:D.: By. .- ' , ' � -,� j , �-S. DI�TB.: ;�'=". f • ' .. ,_, . ... . l ; , . � . - — -- — i -. = , -',_ 't . APPLICATIQN ISSUED�BY:� ' ; : • '-..... 'DATE:' �Z` iS��� � iEikiEiEiEiEiEic�itiEiE'iE�)(-�1tiEiE3tiEiEiFitif�EiE�3,iFF-iFi�iE ' ifi�" � iF7F1E�7E�i �f-�F�f�iE�7F�iE�%��1Eit3(iF,iEiEj'*aE"iF�:i�ic-3E,�F37-��X3fi#- � �,. iE9EdEiEiEifjF?fib%ifY.��lE�E3f�lE�1(�IEifiEiE1E3E3�(��Y.-*iE�14iElElEi61f3fdk�f i(�3E?F iEfF�7EiEdFiEiEif�lElfiflfikiElfiE3EjEiE14iF5f;if'iEd'.i(-?E')Ed4fE)E9fiE3Elf�1'3E�Y. LEGALIZA'PION: N � � P G E S ,_ tM_M Za R� Y; , ' ' STRUCTUI2FL. S�Gt9rN'f : Y `� , ` ;; - :,-.- ., ,p_. � ,. � _#. . .. ; ,..} . , � >• - BLDG PMP � PLUMk3ING •ELLCTRJ� MI:CHANLC�', . ' EIREi iSMIP/REa + GRADIIJ��., ' PGRMIS' _ lOfS;.VO..� . i , ' � .. i'r j �i � s�. - i � , +� 62 .+ + ;. . , - . , , , ' SMIP/,NON'-P.BS,. , � t _y?'� ''ir . K-�:i . . . . �" . . . , . PLr'AN y a � ., , , a 1 '�v � - �4 �7 � �:i ��. . � r . . . .IS:iUG.I?EC _ � ; i . . �t. •-�. . ; r. �.., , . ' r - ,. . ,. ,D[JILDING.-UIV�->_' PERMI�T: ";T.SSUE PT;AN.�CHECK� ' .;a,TOTAL. .•,FAIU'` ' , .�DOE .TOTAIS=--•->i 1:�£1�.+62,.•,�,O.U.O : i;�a'�.}0:0'0' i� :1�0£1.6? ' � �• 1U8.6'2'' , ' .:0;0 . . . i :. � � . . . ' f � � f . o. ..� i , � , . � t , � � s . i . � REV�NOL".•: t)]~V.ISION TOTALa � ='> COLLEC�TFll i � ' 100 :62�' OVER/SHURT: ' ' ' t� : �0 i - . BLDG. PMT F,LUMBTNG�EI,ECTF2IC Mi:GHFiNIG FIRF. 'SM•IP/'POT' `GRI�D7:NC PLAI�I;=CHI:CR.' ' ! :10f3:..00 r . *Y- tJ ��' .Ei^ `' � , �i ,��. '� . . . i.� _7 . '.� '���. �. . �" t �: . _ . . . ... ,�. -�„ . ..: ,, �� '�,. i , . � - , �;�7F if iE iE it-. #'- i£-k if iF� if iE � if };'K fF iE iE fk�iE if IE iE M� IF �IF iE iF jE IEiE'k 3E iE 1fiE 3E if iF ik if 9E IF iE if 3E k'k�# 3l-!E 3E iE �EY.- 3E �E # jf 3f 3F if iE Y,-# 3E.iE �f 3E i( k� IE iE f;E Y�: � �.: ; i.'�. • N o, s: v �i P ti.•A i, ,- ',:� .� F; '�1 iz..e n; t: .� o w rr� "� ;'s ..� � 4 �.. . . .' ' : !/i1� ' : . fi" . �TYPL. .� QTY. :.` D E. 5.0 R jS`i,P T'L' O'N. i.'• �� 4" ": U19ZT� COS'Ci . Y�TOTAL CGS';T : .. ; .. ' ti i ., ; . � i � . i i. . . - SPR � �II0�0 AI.TER' BY ��AI�pF: RES�DLt1T'SAI. A]OZONF. , '1.U0 � t0�F0,0 O,p f, 1 . , i. � ` £NI� �OL' I RES._ . . , ' j ` � � � "{ - _ �.. /{ . �Y.! '! . , - t . .' ' ' ' . . f ,.i 1 � ;`.. . . +- t.� . - .. Xt'; ^� � , � "j � f i� . .� _t.t t i r " � � � i . . 'i , � � . /�. •� �. .. '�. . ' i ' � -; ' �'A/�`y�� 'CTOR \ ' � [�ETE. ' i ' �.' ' , . ', .�IV�VI`� '_ .,', ' r .. ._ '' .p. . . '6 . ' �\�.. 1l.. ,� " � ��i �-,.r� � ��. .� , '�• . l ;\ . • �„? =__'f .. � R ""xe �' � . �: ;i 1 :' �. 7. .: . . � , 0„ �_ ; t ��., .w - ,k- 'ii t. �} . . . - � , � } ' ' : . . . �' :i� . ' ' � . i I 1 . 'I'� � � i . { ' �; . i� : ' ' . • � � i ; ' O 1 OOD54188 .00054189 � T.+J T. � �. - , � � .�. ,lOS.G., ' . ' , , ' ,� . �'' .. DATE: � 02/15l9D :TI17E: t2�03 ' ... , ` .i- . --'. .._ _.. _. , . ' ,�_i. __ ._---._ �_ ..-- •• - , �. _. l. . . . � .� --� . ; '. . �. //( i ' . .. ' ��� . �' � . . . . � .. _ � .�� _. _. .-_._,..__ ._�_,...' ,�. �....'"'_._. �_"'...`_'_ " t - CONSTRUCTION AND PLAN, i_ � -� � `_ • � ,,OL & SPA ' •• c - ; �<; � f� . - ' ' � � �r.. :Date � ,Inspector - �� � � ` Date �- Inspector.. � �. APPROVALS .. Permit #- � r APPROVALs Permit # I� ; ,, , _ _� a' . ti' � . .: . - K . t+rTemporary,Electncal Serviceor�Pole. �..t f - ,- °52 Pool�&�EquipmenCLocanom�z � � � % � +� I� � �2. Soil Pipe-Undrgrnd. ;,�^ �� _;� •. - � 53 Steel-,fleinforcement ' � ; �: � 3. Electrical ConduiTUtility-Undrgrnd - ,f,�j� 54.,Forms �� � ' � � � �� 4. Elect7ical Conduit�-Undigrnd. _ - �<�`." � 55.-Electrical Bonding� � - � �• - . , 5. Steel��Reinforcement . ' � - : ' ' "� '� i� . . 56.� �Rough,Plumbing�& Pressure�Test • 1 6. Electrical UFER-Grndi'=�' • � � � : ��` ' 57. APPROVAL TO GOVER�GUNITE � .. �. , ��.'� 7.� Footings � � . . � , -` �� - �. :: 58. Electrical Conduit�Undrgmd. � ' t; . ., . . . . , 8, Foundation � - , '`';!� � ' � ' � 59. �Gas Pipe, O �Undrgrnd:, l'est � � � 9. Water Pipe-Undrgmd. �' � `_ � � �� ' • 60.-Backwash Lines, B-Trap,.O�Undrgrnd. �. � �; 10. Structural Floor System ��'�� � ..�s� :' �� . , 67.''AP.PROVAL TO DECK-`..-�- � �i - � ; � , �11: Property Sewer Line & Ho'u'se;Connection' /'„ � - � 62. Backwa'sh & �Receptor�Final�� - . .�:,� � i- � 12. Sewer Cap ` .�3,� �' ' E=j �� 63.-Heatec& Vent-Final ' - � ' � '/ � � �.". - ' .,,., � - 13. Roof Drains • � � �. � . 57� : � - - 64. Plum6ing System - Final'�� � ' � ,rh �� . � 14: Rough Plumb^ng �. - ' ' � 65.��Electrical-Final' > . . _ - � .� `; � 15. Fiough Electrical-Conduit - � � -. 66. �Solar System-Final ��� � � � ' i �. . _ ` - . . . ' . . . - . � - .'. �� i6. Rough Electric Wiring_ , - ... . - 67.•�Fencing & Access;Appioval . • � • - 17. Rough WiringSign - �' � , { "�. . � � �68.`APPROVEDrFOR PLASTERING - . w � 18. Rough Electrical�T Ba[ Ceiling "� .� �'r - . '69.� POOUSPA SXSTEMS�FINAL ' ' • .� ,. - . - . _ : . . ,.. .. . , ..� ,.. �. .... ..._.... ,- -. _. � - .' ... ..._ . _�. _ -'-�. . . � _ _....�.. .�._ ,..�.. �- _. . _._ .. _ - . .0 19: Rough.Heating & Air Conditioning_.� , FIRE.DEPT. REQUIREMENT .. . .20. Rough Factory.Fireplace �.' - . - - i-,• :; = APPROVALS:: Permit# � - - , 21. Dutts;.in Structure � " - � '-` � 70.~Underground Hydro ` � � ' - 22. D�ucts �Ven'tilating = .<.! i:;� • 71, product Piping�O Gas ❑ Oil � . - 23. Gas Pipe-Rough & Test " _ " ' ^ ,., 7Q, Underground Flush ` - ' 24. Roof Framing .� � � - �� ` . � � 73. Undergrnd. Storage Tank O Gas ❑ Oil . - . .25. Roof Sheathing �� � -� ' _, - 7q;�Overhead Hydro. ' . � ._ 26, T-Bar Ceiling (Structural) &,Monocoat . , . 75._ Dry Chemical •_ -. � - � 27�. Frame and Flashin9 � � t� � ' . `: :� 76. Dry Standpipe. -� - '28. Lathing&:Siding�;'� ' _ ` " � j���..,j;. �77. FIXED.SYSTEM�FINAL � � � 29. Insulation � � ' �ti'" `�7g, FIRE PREV. FINAL ' ' • � ! �,, �r'' . �HEALTH DEPT. REQUIREMENT , � � 30. Drywall Nailing� . . � I J; ,-; � � < 31. Plaster Brown'Coat� �� - 79. FINAL INSPECTION � . ` . 32. Electrical Power Metec-Final � '- 80,� FO00 CERTIFICATE ISSUED - � '� � ' 33� Einal Electric t� , � �•� ' - " ' � � . . , + ; Notes: �: �- -��fjL ^ ' ' N i � ' . ' _ . , i-f� �y. : ' . / 34. Final Heating & Air Conditioning . ,� j�7j.,;('�• »: �_ w�su.�% � Swiir�n � i%i� � �/L �� � , �35. Final Gas Pipe-Test._ � _ . " � 36. Hood or Canopy " - �: ,' � 37. Final Factory Fireplace � ; : 38. Final Plumbing � � � " ' 39.�Water Service-Final: ' � ` 40. Gas Service-Final� � ' - � 41. Solar pomesticFinal ' � . � i �, 42. Backflow Preventei �� � 43. Backflow Irriqation� - .. �� 44. Landicape Iriipation SYstem� _. ' ' � � - r � �t 45..Sound- Attenuation .' , ' � 46. �Handicap,Regulations � � ' ;� ,.:47. EINALSTRUCTURE&BUILDING . 48. F.INAL PLANNING ' • - �• 49. Electric Release Co-Edison , ` �� 50. Gas Release to Southern California'Gas �. 51: CERTIFICATE OF OCCUPANCY Date 1 " ' . ' \ � � �,�� . K,: r.� - "i ' ' � ,_ • r . . n,.- . _ tl 6 �; � ` . Q �. �� r -y ' �hi i, „ -a •. . : �. : -. " "� : 1,1ti �. ' . ',; � ., �`; �oonessaemimic: 670 W 18TH ST '� �'g�E���"'" MARIE AIRES ,. ��p� 670 W iBTH' ST COSTA MESA,CA �vr�: Yu�wa �ooeess: � . u�cNrt[cT on uaa+�+: UNT: 92627.. , CITY OF COSTA MESA – HUILDING PERMIT PERMIT NO; B 078977 PLAN CAECK NO: 03286-96 L \ � PERM NO: H 078977 �. GOVT: N SUPPc N . CONSTRUCTION TYPE:.V,–N ' PERMIT TYPE: STR PURPOSE: REP , � , ��.: JOB DESCRIPTION : REPAIR 64 SQ FT DECK AND STAIRS SQ FT: 800 uNr: . CLAIM VALUE: 800.00 CALC–VALUE; 800.00 GROUP OCC: R-3 / coxm�c.arsx� FOX CONSTRUCTION COMPANY ( 714 ) 963-6561 cwm�aoxsruudc 19782 RANGER ,�oo�sx HUNTINGTON BEACH CA ucxo.: 579304 92646 uNr: LJCRISED CONTR�CTONS DECLAHATION: I hereby eR�rm under periaMy d perryry Um I em IicenseE uMm pwi�im� d CMqa 9 (comnantlM wilh Sec�im ]D00) d Diveion 3 M iM Bumrou eM Pialevaons COEe. uW mY liceme w in hA face erd Nlea. cm uc. No.: '- , uc. cuss: $ uc. 5 9 3 EXP : -o�e g— ��— 9 � �a���,� �O.l� ,� .— OW NEN BUILDEP OECLAP4TION: 1 hereby etF�m uMm penely M perjury �he� I em ezemq hom Ihe CaMretlae Liceme Lew la qw Idbw'vq �eeson (�ion )031.5 &m'vroae eed Prdaubns Coda: AnYW a oounlY �� �WN� e pmn4 to ewuWn. Mx. impova. demd'oh, or repei eny sliuc1ure, qia ia ile esuence, edo reQuirea �he epplicen� for euch pemiG to fib a eqnad HtlemeM tliel M a�he w IicenaeE pumiam to �M povisions d Ma ConlreGon Limme law �Chepter 9(commerciq wnh Sarl'un )000) W D'v6ion 3 of ihe Bueimm vd Prdeaiona Code� «thet M or eha v mcemq �hereimm end IM Eeau la Ne elbpeE uemqon. lvry vidmion d Seaian ]OJ1.5 by eny epplicent lor e permX eubjaee �he epplicenl �o e civil paneNy of rwl more IM1an fva huM�ed ddlas [5500��. �� 1, es owner d iha pmpeiry a my employew wilh wepes av Ihei ede oompanselbn, xill do ihe xwk, arM qs eWnure u m� imeMM or oflared tor aeb (SeMion 10ad. Busiriesa eM Proleasione Code: The Comredan Licansa Lew does nd eppyto en owirord p�opMy improvemenU ere M intended a diered lor sab. tl, however, iM WiNing w mqwemeM u eoltl xitM1in ww yaer d mmpletion, tM ownerbuiMx will �eve �M buidan d pmviip ha or ehe did nm build or impava t« iM W�a d aeb). � I. ea owner W iM o�roM. � eaduervety mnVeanp wiln IicenmE conUacrore b cme�rua tM prupa (Satlun lou. &nimea end Prdaesbns Code: The Cantredas licenae law daee ml epply �o on owner d qoperry xfa buide a improves IMreon eM wlw wnvacte far wM prqeaa wuh e mMretla(s) IceriuE W��I lo iM Conumas licenee lawl. � I em uemq uMer Seclion: B. 8 P.C.. br thia menn: Dets: Owner: i eo na�nr ronny m� i� e.a,a a�e �oda�i�e ma rea���ans a c�eomm H.ann d,e smar coea s«a�. zssos. nsaa..�w 2553�. eM thet I w erry Mure Wildiip aocupen� will / wdl nu (aicb wro) � �o mmDN �h eeN aiete oodee eM Ihe �epui�emaMs br a pamn famrovuc�ion a modifiratbnhwn�he Aiaiuiy�enpement Dietizl. Reskmlol canqrW ion eppice�iomw namp han Mw qwisans. De�e: � Mdicw: - � WORKEN'4 COMPFNS�TION DECLARATON: I Mreby elfi�m uMer pereAy d peejury ar d tha fdbwinp EeWrNune: . �, I heve eM wil meinten e ceMRieb d conunt lo eeM ins�re Iw Mwkers compevetion, m povidad la by Sr�on 3'!OO W tM laEar I �. Catls.la tM pMormence d IM xvh tn wlJch �hia parmn u iauad. ' �,. ��f i i,a,. d,e �;� �md, woM�• �v�o� �owre�. m�a���a nr sea�, a�oo d mo �.b« wae. m, m. rorto�� a m. ��, work lor whieh Ihu peemu ia'seueE. My wnken' mmpeneelion ireurar�ee wrix eM pofiey number ve: , . c�: STATE FUND • EXPIRES - ra�r+�m�: 10/31/97 "(ihia secfion rreed nw be candeleC i tM perm<u lor om hundred ddkn (SlOpJ w bas.) - ❑ I cenAy thet in ihe perlormeru.a d IM xrork la whch ihie pemiu'v ueued, I ehdl nd employ eiry pason n em� menmr eo m lo . bxwne eu4� �o ine womm�' comva��� bwe a celAomle. ana au•� uw a necon. w4b �o �ne waM.• mmp�aiuIe�ion pa^rieiom d Se/dian 31W W tM laboi COEa, I '(��//�^p�y h u pv+iviom. Dele: Il � L ��r{ APVlicent: /t�L'C.C.G � _ ��%!�1 ' 7' Wamliq: Fell�n� ro a�cu�M�'romp�rwtlon roven0� l� unkwM, �ndelull �uD/�cf m xrployr ro cNMml p�nWr anJ C/VII AM� 1¢110 MI �IWIQ/Id (�IOUHIIdl�O�H/� (f100�OLVf� In I✓fIICOII N M/ CO�f O/ roI11pNW(bR ��� M(MOV�(/IO /OI �/1 S�ctlon JI06 0l N� Lebor Cods, inhrul. �M attomsy'� Isss. CONSTRUCTION LENDINO�AOENCY: I hareby �rm uMer penelly ol perjury ihet �hme n a eontlrud'an Wdiep paney lor tM �no��. a me won �«.nw� me v«m� ro m:�aa �seao�, xe�. cw. c�. � LENDER'S NMIE: ' ' } IENDEN'S ADDRE%: I cerlilythm I here read I�ia epplcetion eM a�eb Ihel ihe ebove inlameiion is mrtea. I epree to compN �h NI tlry uM couMy adineM.ae W�tale lawa Meliq lo WiN�q cmnrudion ud Mreby e�nMr¢e �epesenla�ivee d Ihb ary�o en�er �pon iM ebo-re�memionatl papMy Ipinspeciion pu�posea. • HII�L PETERSON Pnnl Nema 00 �.Aa» , o�a: -� �2.-96 , qneNre d OwrednpenVAppYranVComreaa � (5151<B.WP) W�ile-Buikiq 8 Selery; G�le; Cenery-Appficant; Rnk-Revenue; GddenmFbamar COMMENTS: REPAIR AND REPLACE DECKING AND, STAIRS ***�**�*������+�*��*�+�*��+�*******��*��+��x��*�***��*+�*�x*�x�*******���**�x+��r*****� Z O N I N G R E Q U I R E M E N T S S E T H A C K S ---------- – MAIN HUILDING ---------- --------- ACCESSORY BUILDING — ------- FRNT: FT IN REAR: 50 FT IN FRNT: FT IN REAR: FT IN LEFT; FT IN RGHT: 12 FT IN' LEET: FT IN RGHT: FT IN PARKING REQ: PROV: PARCEL; 42424129 ZNE: R2HD REI' NO: PLANNING NOTES> REPAIR EXISTING'DECK (AT 2ND FLOOR LEVEL) BEHIND 6 ATTACHED > TO EX,•APARTMENT UNIT. :kr• ' if * ik it iE 3E iF 1f iE iE iF 1F'lE if iE �k 1f �E �F dE iE 3E 1E iE 1E iE iE 1E 1E iF if iE iE if 1f 1E ik ik iF 1E iE iElE iE 3E iF dE �lE 1E 1E 1E if 9F iE 1f 3f * �F'IE �IE 1E 1f -)E 1E if if if'X��E.iE �F 1ElE-IE i(� iF 3E �F �E D E V E L O P M E N T S E R V I C E S R E Q U I R E M E�N�,T– S , . ZONING APPROVED HY . � P � DATE: '–IZ'��i BUILDING APPROVED HY ;_�-��-, 1.� DATE^1 'c�� I2�9�o APPLICATION ISSUED BY: � ' _–������ DATE: .3' U'� f@1E1F,jFiE3fiEdEififiEjEiEiFiEiEiFifiEiElEiE jE3FiEiEifiEiEif1E�E, jE1E LEGALIZATION:N , - F.E E S.0 M M A R.Y ' STRUCTO$A�li�SEGMENT:Y • BLDG PMT PLUMHING ELECTRIC'' MECHANIC FIRE SMIP/RES; GRADING PERMIT 29.25 - ', . .SO ' PLAN 19,01 � '� ',��'�' SMIP/NON–RES �% i ISSUE FEE • ^�� " ' BUILDING–DIV–> PERMIT ISS,UE P.L'AN-CHECK TOTAL' PAID DUE TOTALS----> 29.75 0.00 ,`" "'19.01 48.76; 48.76 �.-.00 �li REVENUE DIVISION TOTALS--> - COL'LECTED�� 48.76 OVER/SHORT: .'00 . BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE �SMIP/TOT. GRADING PLAN-CHECK 29.25 � -',,% ,50 19.01 �. � � +•. t�- fE 3E �E iE iE �E iE 1E iF iE �E iE 1E iE 1E iE 3E iE 1E *�E IE 1E �E iE 3E 3E iE �E �E iE if IE dE iE.lf 9E iE iE 1E �E iE 3E iE 1F 161E iE 1E 3f if iE iE jf �E 3E iE iE iE iE iE IE iE if jf �E iE 1E iE iE iE iE 16 it 3E fE �E 1E iE I,N D I V I D U A L ",F` E E B R E A K D,O W N TYPE QTY D E S C R I P T I O.N�Y � UNIT COST TOTAL COST SFR 800 'ALTER BY VALUE RESIDENTIAL NOZONE 1.00 800,00 -END OF FEES Y f' � � J;. 1. • d7f i��l�1.55? :03:`2°`4�, 3a�i i r;.,., �Ri:: _:i�.. .. T�I:a'�' -r,•'-i a �a �. , _� . �•_. _�--- =-= - � - _- - - __ _ . . ti �'': CONSTRUCTION AND PLANNING„ _ � � _� � �POO'. ,PA ' ' . �t : � �' % APPROVALS :Permit# -_ �BDate �Inspector ', AQpROVALB.�;Permit# � ° ' -' Oate'. Inspector � . , r !I ^` t. Temporary:Electrieai Servlce or�P.n{e- T _ • °!; . �52'. 'Pooi & Equipment Locaoon^'" : ` , "j.�i . a ,fi �� 2. SodvPipe-`Undrgrnd � ; ,� o ° " ; `` ! b3: Steel fieinforcemeni , � i, f,� � ;i I _ � . .i � 3r �Electrical Condwt Utllity Undrgrnd ' ` - ' : 54: Forms � � • � � ; - � ;f3 6 _ - _ .� .. . ' .. .. � _ 'r. .1 .. ' . 1 , ,a.�. . , ,I . "4 . �; � � . Electrical Conduit: Undrgmd. (;-� � `55.- Electricai Bonding . ,,� _ - .,}- � i, 5. Steel Reinforcement- �" ' � - - ' � � ' ' , _ , � ' . 56. Rough Plumbing & Pressu�e Test � . . � �- 6.�;Electricaf UFER Grnd. . ' �-� � '� 57. APPROVAL TO COVER�GUNITE• ' _ , t�� ' �' . 7. Footings ' �- � . � . � �58.- Electrica� Cqnduit Undrgrnd: . . - � . 8. Foundation �_ � ' _ � _ .. s � ,59. Gas Pipe, O,Undr'grnd.,.Test� . ,� . . 9. Water Pipe�Undrgmd7 � r� � ..�; � . , � _ - 60. Backwash �ine;,P�Trap,-O.FJ�drgmd. � ` � 10. Structurai FloorSvstem - � �-! -- �� - , i '67. APP,ROVALTO'DECK , � ' � � ; ' 1 t. �Property Sewerline & House.8onnection� � � - � ; 62. Backwash &"'6eceptor�Pinzl�.' , � . � i. ! 12. !Sewer Cap = - - .: �"i . � . ' �,63: Heater & Veni�Final � ,•� �� .� . 73. Roof Drains . .+. _ � � - Yg4'. Plumbing SYstem -'Finai ,{ .�- � � 14. Rough Piumbiny l" � ��t ��� . 65. Electrical-Fanai � � - �; 15. Rough Electrical-Condult ,,. 6; ' � � '66. Soler.System-Final � + -' - - `� ( d. . .. � . u. . '� 16. Rough Electric Wiring � � ' � � � ' � ' " " � � . 67:. Fencing & A"ccess-Approvai � �j 17. Rough Wiring Sig� `� ' ' ' - ` � ,6$. APPROVEO FOR�PLASTER WG • � ,r � . 78. Rough ElectricabT Bar Ceiling , i,_ �`' � ." ' 69. POOUSPA SYSTEti1S FINAL . 'F r' � u ' d.g,.Rou9h Heating & Air.Conditioning .� _ - - . : .. - FIRE DEP7. HEQUIREMENT - - � . � - - 20. Rough Factory Fireplace � �. - r ' . � APPROVACS'� ' Permit # ' � - vi - - � - n, c. - - � �" - 21. OuctS, in Stru`,cture.'� .." . -- ' �� ,- y - 70. �Underground Hydro .� 22. Oucts, Ventilating- y " � -- 7�, Product�Piping*O-Gas COiI 23. Gas Pipe, Rough & Tesc � c, � `' "�, 7z, Underground Flush , - . 24. Roof,Framing. � -� - �•!- _ � '- 73. Undergmd. Storag2 Tank- G� Gas ❑ OiP 25. Roof-Sheathing �' � � . `�" , " ' '� ' 74. Overhead Hydro ' � 26. T�Ba7•Ceiling (Structural) & Monocoat .�^ -�- - _ 75: Ory Chemical J '� �< - _ 27. �Fiame and Flashin ' � � � �� ' , g y � . r � - } 76.'��Dry StantlPipe." t. � ' - '28. (.athing&Siding;;, . � � ``� � � _ � � 77�.�FIXED�SYSTEM"FINAL � � - - �� 29. Insulation - � � = ' " - • " 78. FIRE PREV. FINAL '� � � t- 30. DrywaiV Nailing �ir "� ' � � � �� � � . - r-HEAIT;H OEPT: REQUIREMENT `�. 37. Plaster Brown Coat" _ ' • � 79: FINAL WSPECTION .; ' ' _ F r `' E. 32. ;Electrical�Power Mefer;Final � �_ - : �-i � � � - 80. FOOD CERTIFICATE ISSUED _ � . 33.,Final Electric_ r. �r � : �' �" , ; �'� Notes: �/��/�=�`��„f�.'pr� � �v _�� � , 34. �Final'Neating & Air `Conditioniny ; `�_ �- ' � �. � , �X � ��.�; �ak _ ,/�,.,� � Q o ,fi� % • _ � _ . v- � 35.�FinaPGas`Pipe'-l"est,T „'�' -:F ^� , ' .. � ^� _,. . ' '� � 36. Hood or �Canopy �� . � ._ �• ; � . �. � � �`•!�i=�� ' � 37. �Final'Factory Pireplace' . ., r ' ,`. � . � ,_ c. "� . . -_ p . . . - . . --- � 38. Final�Piumbing _ �� � _ - _; � . � 39. Water Service-Final * � � _ � � • � ' - ' 40. Gas Service-Final ' � _ ' ' � , 47. Solar pomesticFinai . � •• : • r� " � . ' i: � r' �';�, .� 42. Backfiow Preve�ter.. `�. . . : _ ' - � - - 43. BackflowJrrigation,. � • �"� ` � ' � _ � - '- , - 44. Landscape Ir'rigaxion,System- :- ; ��. ;: { :-„ : , ' • = . �45. �Sound Attenuation - = �� � � -- ^ �'` ' "� `� �-, • - I �46. Handicap fiegulations ;_ " � � �-� ` -� `� _ � 47. FINAL STRUCTURE & BUILDING '; � - - `,�y�q6 %� -� _ : _� _ 46. FINALPCANNING, . - „ , - s, .49. Electric Release to Edison ' ."' ';-�' " � - � .50. Gas.Reiease to Soutfiem California Gas Co `- � � -`. -= - • ' 51,. CERSIFICATE OF OCCUPANCY - - ,- , �: �'`. No. -- Dace -_-- � odecr nooeess: 6 7 0 W 1 8 TH S T OWNEX'SNAME: LOFTIS, JULIETA aoonEss: 670 W ,18Tfi ST COSTA MESA,CA AflCNIENGINEEfl: aoosess: UNIT 92627 flEG.NO.: uxir: PEHMITTEE: BEST ROOFING ( 714 ) 557-9040 AOOflE55: ']EjS ST CLAIR B COSTA MESA CA 92626 UCENSEU CONTBRCTOP UECLAHATION: I here�y aifirm ��a� I am licensed unUer provisions o� C�apter 9(commencing with Section 7000) of Oivision 3 of Ihe Business and Pmfessions Cotle. antl my license is in lull lorce antl eflec�. ciTvuc.:051718 sT"TEuc.:603323 cuss: C-39 '6ate: —��'� • �� Si9naWre �" WOPREBS' COMPENSA710N �ECLl�XpTION: I here6y aifir�� I have a cerii�ic ot consent to seli-insure or a cenihca�e ot Workers' ComDensalion Insurance, or a cer�ifie� copY thereol �Seclion 3800. Lab. C�. aaucrxo.:1137512-93 E%P.DFTE: OE/OSI9�! comraxr: STATE FUND ❑ Ceailietl copy is here�y lumis�etl. m Certifietl copy is IileA wiN �he ciry Building Division. .ga�e: L� '� ApplicanL � E%EMPTION FBOM WOflREBS' MPENSPTION DECIABATION: (This 5eciion neeA at be campletetl A �he permi� is for ane huntlretl ($100) or less). I ceriily Iha� in Ihe pedormance ol ihe work lor whic� this permi� is issued, I all no� employ any person in any manner so as Io became sublect to I�e Workers' Campen5alion Laws of Cali�omia. Da�e: Signalure: NOTICE: If. alter making �his dedaration, you shaul0 Uecome subleci �o fie Workers' Compensa�ion provisions oi ��e Labor Code. you musl fotlhwilh camply wiih such pmvisions or Ihis permii shall be tleemed revoked. ' CONSTflUCTION LENOING AGENCY: I �ereby aflirm Iha� Ihere is a con5tmciion IenOing agency lor the peAormance al �he work for which Ihis permit Is Issuetl (Section 3097. Civ. C). IENOEH: AOOBESS: OWNEfl BUILDEB OECLANATION: I �ereby af�irm Iha� I am exempt irom ihe ConVac�ors' State License Law for ihe �ollowing reason (Seclion 7091.5 Business antl Professional Catle'. Any city ol coun�y which requires a permit to constmct. alter, im0�ove, tlemolis�, or. repair any simc�ure, prior lo its issuance, also require5 ihe a001ican� for such Dermil Io lile a signed s�a�emen� Ihat he/she is licensed pursuanito Ihe pmvisions ofthe Conlractors' Staie License Law�Chapter9�cammencing wi�� Sec�ion 7040) ot �ivisian 3 o�the Business anA Pro�essions CoOe� or thal he/she is exempt Iherelmm antl �he Oasis for the allegetl eaemption Pny violation of Seition 1031.5 �y any applican� br a permit sublects �he apD�icantlo a civil penalry oi not more lhan �ive hunAreU Aollars (5500). � �� � i, as owner o� Ihe pmperiy or my employees wilh wages as �heir sole compensation, will Oo �he work, and �he stmc�ure is not inlenaetl or oftereU lor sale (Section 700C. Business antl Vro�essional COJe: The GonVacbrs' Siate LicenSe Law tloes nai apply Io an owner o� a pmpetly w�o builtls or impmves �hereon, antl who tloes such work �imSelVherself or thwugh his or her own employees, O�o�itle0 �hat such impwvemenls are no� inientletl or o��eretl �or 5ale. Ii, however Ihe builtling ar improvemenl is soltl wi��in one year oi complelion. Ihe owner wiil have Ihe bur0en of pwving �e/she Ji0 nol 6ui10 or impmve for the purpose of salel. I, as owner of ��e pmpetly, am exclusively comraciing with licensetl contracmrs Io conslmcl t�e pwle�� ISection 704a, Business antl Pmfessions Cotle'. The Contrattars' S�a�e License Law tloes not apply to an owner of pmpehy who builtls or impmves Ihereon ana who contracis lor sucli ymlecls wi�� a contractor(s�license Oursuantto the f.nniraclors' Sta�e License Law),I am aware ��at pmof oi Iheir Worker's ComDensa�ion insurance s�ould be D�ovitled to me. I am exemp� untler Seclion: B. 8 P. C. lor Ihis reason: ' Dale: Owner I tlo �ereby certi�y Ihat I am aware ol antl unaerslan0 ��e requirements ol Califomia Health antl Salery Code Sec�ions 25505, 25533, antl 2553d antl Iha� I or any �uWre builtling occupant willlwill nol �circle one) need to comply wi�h saitl s�ate coaes antl Ihe requiremenls for a permil lor consimction or motlilicalion �mm t�e Nir Oualily Managemenl Oistrici. ResiOential con5imc�ion applicaiions are exemp� fmm Ihese provisions. Oale: Applicani: I hereby cerli�ylhai I have read ihis applitalion antl sta�e Ihai the above ortlman[es and stale laws rela�ing to �uiltling conslmtl�on and �ereby aulh property Iorin508cp�ion purpo5es. Oaie: �Z ��� I 1 SignaWre: � Oriver's License m Social Securiiy a: is correcL I agree �o comply wi�h all ciry and coun�y nlalive5 0� this city ta enter u0on �he ahove-men�ionea i641-4fi White—Builtling; Green—Cotle Enio¢emenL Canary—ApPlican�', Pink—Revenue: Goltlenmd—Assessor CITY OF COSTA MESA — BUILDING PERMIT PERM NO: H 06515`_ PERMIT NO: B 065155 PLAN CHECK NO: N GOVT; N SUPP: N CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: ALT JOH DESCRIPTION : T/OFF RESHT. REROOF W/COMP SQ FT: 2,957 CLAIM l7ALUE: 2,957.00 CALC—VALUE: 2,957,00 GROUP OCC: R-1 / COMMENTS: SMOKE DETECTOR REQUIRED PRIOR TO FINAL �-**�*�t*********at****�c*****it*x�******�-**�--�ie*******�*+�**�c******+t*�c**�******�**�-+�** Z O N I N G R E Q U I R E M E N T S S E T B A C K S 1r -------------MAIN BUILDING ---------- --------- ACCESSORY BUILDING --------- FRNT: FT IN REAR; FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGAT: FT IN LEFT: FT ' IN RGHT: FT IN PARKING REQ: �� PROV: PARCEL; 42424129 ZNE; REF NO; PLANNING NOTES�; L` if iE iE if if if iE iE iE if i4 iE iE �F�'�E�if �E it 1E iElf �E iElF # iF if if iF ah ii iE fk aE 1E �E if * iE ik if iE iE jE 1E iE 1E if Yr k iE iE 1E ff iE iE 1f fE-)E iE iE if iE jE 3f if iF if ih if if {E jE if if 1f iE?E �14 D E V E�L O P M E N T S E R V I C E S R+E,, Q U I R E M E N� T S ZONING APPRO�� D BY DATE: .'� BUILDING APPROV'ED BY : DATE: .� APPLICATION I SUED BY: �� DATE: 'Z�2 ��� 'lf iEif 1E'1EiF'lE iE�t iE iE�1E iE.ic�iF 1E'N'iE'7't iE #E !E�'SF h;h ?f i�Fl('�r. Y-� 3t tf iE iflf if #�lE')E if 1E�If� iEiF-lf if �E 1F iE if fE if �klF 1E 3F jE if iF jE iE 1E iE 1f iE �t iE iE iE iE iE iE * if iE jF iE 1E 3f iE 9E 9t ft aE iE 3E if iE iE if 1f jf 3� if iE iFlf jf iF iE jF if 3E iE 1f 1E iE iFlE 3f jG �E if if ib,�jf iE fE #� iF jE if i(�>={p LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y BLDG PMT FLUMBING ELECTRIC MECHANIC FIRE SMIP/RE3A GRAL�ING PERMIT 54,00 /� 5'0„ PLAN � �f SMIP/NON.�RES ISSUE FEE ` ry �F BUILDING—DIV—> PERMIT ISSUE �LAN�CHECK •TOTAL PAID �i DUE TOTALS----> 54.50 0.00 � 0.00 54,50 59.50 ,00 l�i REVENUE DIVISION TOTALS--> COI�$ECTED: 54.50 OVER/SHORT: ."� 00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING%f;�LAN—CHECK 54.00 :� � .50 � a- L " iE 3E jf iE iP iE iF iE iE iE iE fE iE iE if if iE if iE af if if iE if iE iE iE iE iE i4 if 1f fE if if 1flit� iE iE 9E iE iE 3F iE if if iE �E iE jE iE iE if iE if iF iE iE iE i6 iE # iF if iE 1ElF iF �F iF #'N� if if if if iE it I N D I V I D U A�'73 F E E B R E A K D O W N t= � i� TYPE QTY D E S C R I P T I�O N UNIT COST �OTAL COST %� SFA 2957 REROOF BY VALUE RE-SIDENTIAL NOZONE 1.00 �;. 2,957.00 :�END OF FEES `;/ /t i • �; f n�' ��� �1 t1Q15�/�45-00151646 T O T 54,5� D�TE: .1.:lp2!43 TIFiE: t;:22 CONSTRUCTION AND PLAf�NING_ -. ' =' , • APPROVALS Permit # Date � J •. � i.,Temporary Electrical Service%or'Po7e � `! '� � .. '2. Soil Pipe-Undrgrnd. - �''� - ` , ;, 3. Electrical Conduit Utili[Y�Un$rgrnd. � � � .4. ElectricalConduit�Undryr'nd.�� -'� . ! - ; � - 5. Steel Rein!orcement � ' 6, 'Electricai UFER Gmd. , , ' 7. Pootings - � � 8. Poundation `�,! - ���' � i �.1 -' t __ � . 9. Water Pipe-Undrgrnd. ; �-.;� � .:., 10. Structural Floor Syszem� .� � �%� ./�' % .'i. 71. Property Sewer i�ine & Hous�GSnnaction ' : �� 72. SewerCap � ,. �� 73, Roof Drains . , � - , 14, Rough Plumbing . , 75. Rough Electrical-Conduit �. � - 76. Rouqh Efectric Wiring - 77. Rough Wiring Sign " _ , >_ 18. Rough Elearical�T Bar Ceiling 19. Rough Heati�g & Rir Conditianing - �� 20. Rough Factory Fireplace - 27. Ducts, in Structure . . 22. Ducts, Ventilating 23. Gas Pipe�Rough & Test 2A. fioof Framing - 25. Roof Sheathing . -� � �3.`� 26. T-Bar Ceilin9 (Structural) & Monocoat � 27. Frame and Flashing 28. tathing & Siding 29. (n5ulatiOn 30. Drywall Nailing 37. Plaster Brown Coat . 32. Electrical ?ower Meter•Final - 33. Final Electric 34. Final Neating & Air Conditioning 35. Pinal Gas Pipe�Test 36. Hood or Canopy - ' 37.-�Pinal Factory Fireplace . 38. Fina� Plumbing � 39. ��Vater Service-Ffnaf 40. Gas Service-Finai � 47. Solar pomescicFinal 42. Bzckfiow Preventer . 43. Backflow Irrigation -44. Landscape irrigation System 45. Sound Attenuation 46. Handicap Regulations ' ' - - - POOL �PA � . ` Inspector APPROVALS Permit# Date e e 9 47. FINALSTRUCTURE&BUILDING !�_��R3 �,�, 48. FINAL PLANNING � 49. Electric Release to Edison ; 50. Gas Release to Southern Californla Gas Co 1, INo. Date . 52.. Pooi &'Equipment Location � 53._Steel_ ReinforcemeM " � 54.• Forms- - • 55. Elect'ricel 8onding � - _ 56. Rough� Plumbing & Presswe Test 57.� APPRQVFl�-TO COVE.R�GUN!TE � r 58. Electrical Condu�t�Undrgrnd. � 59. Gas Pipe, �-Uniligrnd., Test . 60. 8ackwash F.ines, P�Trap, C�� Und: gmd, 67. APPROVAL.TO DECK � 62: Backwash &�Receptor-Final 63. Heater & Vent-Final � 64. Plumbinq System - Finai - 65. Elxctrical�Final� " � 66. Solar System�Fina� , " 67. Fencinc� & Access Approv3l 68., APPRQVED FOR PLASTERING 69. POOL/SPASYS'iEMSFINAL FtRE DEPT. REQUIRENfENT APPROVALS Permit $-` 70. Underground Nydro 77. Producx Piping G' Gas 170i1 72. Underground Flush � 73. Undergrnd. Storage Tank C Gat ❑ Oi! 74. Overhead Hydro . 75. Dry Chemical � ' 76. Dry Standpipe 77. FIXEp SYSTEM FINAL � 78. FIRE PREV. FINAL HEALTH pEPT: REQUIREMENT 79. FINAL INSPECTION 80. FOOD CERTIFICATE lSSUED � Notes: �'J � }i N 0 �'! CJ�,`` ����// �� I ,5N%; c�� Inspector. e: :� , CrrY oF CosTA nnESA . CONSTRUCT ON PERMIT , —o.f.�... eaa.o« l %O L�.� / � � � . . icant to till in all sPaces except tnose within heavY bortle� li ;��r �.sas i-. i ' .flpplicanYs Mailing Address, /� - t� TVPE OF CONSTRUCTION- . , rvEw "aDD �U �-/ E "GOF�T� S �- � CONVERSION "❑ DEMOLISH .❑ OTHER Owner's Name PhoneS'� Q�n'uj ' DESCRIPTION OF WORK/USE OF BLDG. — Address �'7D �� �� � ��� • . . , . . eeclarations. 4 ALTERATION REPAIR Arch/Eng. License No.' � g`r�/^� TVPE OF PERMIT GRADING��l� FOUNDATION . LJ STRUCTURAL Address' � /��� /� - . ❑ TENANT ❑ ELECTRICAL Ll aLUMBING ❑ MECHANICAL Cont�actO�SNd P "'T(�� phnnn6�SSS$' �'OTHER '- - � ' � Address (m� ���91 ��le %S PROJECT DESCRIPTION SQ. FT. � OCcuPANCv_ City�License No. O eZS�793 � ZONESTRUCTION TVPE VALUATION $ LICENSED CONT0.ACTOR DECLARATION � I�hereby affirm Ihat I am�licensetl untle� provisions of Charter 9(commCncing RemarKs: �_ with section ]OOO) of Oivision 3 of the Business antl Professions Cotle, antl � rtty license is in full fOrte antl effecL • � g` License Ciass � License No. ✓ Dare '����.�r�� Signature � ' � WORKERS' COMPENSATION D LARAT�ION � . . ' � I hereby'afiirm tnat I nave a certificate oi wnsent to self-insure or a certificate -�f Workers' Compensation nswa o�5 S,certifie�y�t��hej{}�of (Section � _ � 1800', Lati. �cFy/ � /����� y���%�Qb'/ , �/ 1 . ' ' � �Policy No. �� Co�4pany �_� �1��'�'�'��'� ertitietl copy is he�eby tumisM1etl. ; �� rtifietl capy is (iletl with �th.�city B" ing Division. • . ate�-�%—&� APD��ant � ,EXEMVTION FROM WORKERS' PENSATION DE LARATI N ' '(TM1issection neetl not be mmpletetl it'the permiYis tor, one huntlretl ($300) or , . 'less). � ' ' ' � I certify'that in the performance of the work Por which this pe�m�t is issuetl, I - shall not employ any pe�son in any manne� so'as to become subjeGt to the Wo�ke�s' Compensation'law5 of Galifomia. __ � - i. . pate $ignature 'NOTICE: It, aiter making this tleclaration, you shoultl become subject to the Workers' Comp¢n5a[ion ptovisions o( [he Labot Cotle, you must (orthwith _ compry with such Orovisions or this Oermit shall be tleemetl revokeG. CONSTRUCT�ION�LENDING AGENCV{ � - " � ' � I hereby affirm that ther¢ i5 a construction lentling agenty for�the per(o�mance ,_ ot llie work for which Ihis permit i5 issuetl (Section ,3097 Civ. CJ Lentler's Name - lYntler'S Atltlre55 ' _ . OWNER BUILOER OECLARATION ` � � � I hereby affi�m that 1 am exempt trom the Contractor's License Law fo� tM1e � followinq reason (Section 7031.5 Business antl Professional Cotle: Any city or county which �equires a pe�mit to const�uct, alte�, improve, tlemolish or repai� any sVucture, prior to its'issuance, alzo requires the applicant for such permit ' to tile.a�signetl statemenbthahhe/she is licensetl�pu�suant to the provision5 ot the Contractov'S License Law (Chapter 9(commencin9 with Section ]000) o( �' Division• 3•of the'Business antl Protessions Cotle)'or that he/she is exempt therefrom antl the basis tor.the allegetl ex¢mption. Any violation ot Section ' ]031.5 �by any applicant foG a, permit subjects tne•,applicant [o a civil �penalty of not more than five hundretl tlollars ($500).. �. ' : � ❑ I,�as� owne� of the; property,o� my�,emploYees with wages as their sole compensation, will tlo the work, antl the structure is not intentletl or offeretl', for sale, (Section 7044, Business and ProfessionaP Cotle: The Contractor's' Lirense Law Ooes not apply [o amowner of a property� who builtls or improves' thereon, antl�who�Goes sucM1 work nimself/herselYor Ihrou9h M1is or'her own . employees, provitletl thal such.imOrovements are mt�intenGetl or offeretl tor • sale. If, however, the builtling or imPtovement is soltl within one year o( com- pletion, the owner wilhhave tne burtlen oi proving he/she ditl not build orJm- ' prOvelfor tlte pu�pose of sale). '- �'! , � ❑ I, as owner of the proDer[y, am exclusively cont�acting witM1 IicenS¢tl con- � t�actors lo conSVuc[ the pro�ect (Section ]044, Business antl Profe55ian5 Cotle: The ConVactor's License Law tloes not apply to an owner of oroperty who ' builtls or'im0�ove5 thereon; antl who conVacts for such projects with a con- � Va[[or(s) license pursuant to the Con[ractor's �icense Law). I am aware thaf , proot of [heir Work¢r'S Compensation insu�ance should be p�ovitletl to me. ❑ I�am exemp[ untler Section B. & P. C. fOr thi5 rea5on _ GRADINGCU.VDS. ACRES_ Bar Sink BackflowPreventer- - - Backflow Irr�gation Bathtutis � Clanfiers � ' � � n:..�.......�.e. � . - ioor v�eurs , . loor Sinks� � - . ' asService � � ?Outlets� �- icerceptors' � � itchen Sink . � � avatories, * _. •- � —Trao ... � . , , ' �'.Reinspection Fae "� '$15 Boiler ' -. . ' Duct - Under Ground Duct - Structural Duct - Ventilating i_ _ Exhaust System ❑ Multiple ❑ Firepl/Fact.Blt.ICBO�# , Date ' Owner Heating System & Ducting '�I hereby. certiry•that I nave read�tnis�apP�ication-antl-state�that-the above - •-'� �0.100,OOQBTU �100,OOOBTi informatmn �s correct. I a9ree to comply with all city antl county ortlinan<es � antl�s[ate laws �elatin9�to builtling construction, antl hereby authorize repre- , - - sentatives oh Ihis city to enter upon he ove-mentionetl '.Property for � ' , , inspection purpa es. � ' Si9na[meL 'w""�'d� � � Date / �7 %� e . , � . Drivers' Ll ense or 55 � �� Reinspection Fee $75 _ _ ' ' "_ '.. .. '_ _ _._ _ .._ ' _._ . _.... . . _. . _. _. _ ., _. 9F 0865�46, rev. 10/84 White - Builtling; Canary - AOP��cant: Pink - Accountin9; Goltlenrotl - Assessor Showers Service Sink ' Sewer Cap-� Sewer Connection Solar Collectors � Solar Piping� ' ' Solar Tank ; � Swimming Pool w%Spa, � ., t A.P. �k S Main Building: E T Front A Rear C Right S�eft Ping. Ref. # Planning Notes: . . _ . . 1 . � _ _' ., +_ . \ ' . � � 'eaai. ii2eias ' - a'{ • .. . � ' ZOfIB'' -+...5Yoo1'�I � � � Accessory;8uilding: � �> ' � . ' . � i ' .. •. .O ' . . . � � ,.. . N . � Automatic Washe[ �� , Construction Pole Sub. � ' ! � Cooking Unit .� � i . — Drsliwasher � � � Dryers �Gas DElectric ' Water Heater - - • � Water Service • �Auto-Wash , � Laundry Trays. � ' - i ' � .. _ . � � � - ' ' Issue Fee . ' � Hood or' Type I' �. . Canopy ; Typelh ❑ Retrigeration System ' ❑0-700,000 BTU ❑ 100,000 B System Repair/Alteration , � Fire Dampers . ' : � s ,, � � . , � i � . Issue Fee � $ 3 r � $ 3 F.A:U. Fixtures Device Boxes ' Outlets' � Switches Gaibage �Dispoul Generami 00.5 KW I Parking.Req./Provided ^ ' ELECTRICAL .. � FEES �Transformer��� 15-50KW ' ❑ SO+KW Meter ❑up to 100 amps i' Meter ��over 100 amps� 'SuhPanel � . ; ' �'i. ..'�' 15 KW � Reinspection F,ee• • . DEVELOPMENT SERVICES R Zoning Approved By Building Appioved By ' Momrs OO-1 HP O1'/:.- 8 ' •Inc.Solar 09-15 HP �16-15+ �� 'Microwave " -" ` ' '-" � Pole Light � � ' � � + Range � . . ' Si9n - � t Standing,Sections ; Trash Compactor � !_ �ue Fee � S� I N. ` G R � E; , Q � M T S APPlication Issuad'BY � �� ' ` Date 1 �J'K '-6(� � - �SUMMARV OF FEES . � � I , � BUILDING PERMIT ' $ - � SMIP� ° $ � -� � �� PLAN CHECK $ � PERMIT � � � �� , � ' PLUMBING , $ .J' V�/ ISSUANCE � $ � PLANtCHECK 25%� $ ENERGV P.C. i$ � � � .ELECTRICAL�� $ � ' GRADING �$ • � 1 ' MICROFILM $ � �' � ,�� PLAN•CHECK 50% $ � .3 � I � ! �^„ MECHANICAL , 1 $ TOTAL FEE ; $ '�� { f "� ' � 7�PLAN�CHECK ;25% $ ' , 1 ' � �, � -:_ \ � '' i . ' ' - ? POOL .,� a. A - ��- COiVSTRUCTION'AND.PLANNING': ' pJ..r ^ " � ��' �� ° _ ' " ?�,''� i ���!�1PPROVALS � Permit # " Date - : Inspector ' ` APPROYALS . Permrt # � Date'� InspPcmr, i '; . � _i � 1.;Tempgrary Electrical Service or Po�e � ' �" � '„ . - � 52. Pool & Equipmentlocation- � . -' � ' � � ^ . ' �2. Soil Pipe-Undrgrnd.. y � !')' _ ! - -53: Steel Reinforcement. � - � . . � : ' 3 � Electrical Condu[t�Utiliiy, Undrg�nd. -�! " -=a.' ' _ 54. ,Forms � - � . : - , � ��4:.Electrical,Conduii-Undrgrnd.. -�` .: ^ _ " • � 55. Elecfrical Bonding L ,-_ - ` -� ,. � , 5. SteeF�ReinforcemerSY � - . ? �„ , - . < �-. 56: Rbugh �Plumbing & Pressure Test� � � " � ����f/' . r ' - � � � :6. Electrical UFER'Grnd:� "f;'. - - � � : � � 57. APPROVALTOCOVER-GUNITE � - ''�� a .i , �,: � ' 7. Footi�n9s_ ���° ' . � `�'' � - _ �� ' z _58�. Electrical�Conduit-Undrgrnd�. - � � � - � } ' � 8:`:'Foundation' ' � . - � � � . -59:'Gas Pipe, �. Undrgrnd., Tesf � - . %� i`� �: . � ' � 9. Water Pipe-Undrgrnd. ' � � ' ,.,a' - ' - _ " 60. Backwash Lines, P-Trap; ��Undrgmd. � , "' •10. Stiucwral Floor System ' , � .. 6T: APPROVAL TO DECK ^ - � - � ' , - �1;1. Propeity Sewer Line & House Connection . � � � � �; 62. Backwash & Receptor-Final'��� ' � � - �� \. . �!. " � � ' � 112. Sewer'Cap'^ ~ " • ' � ' ii� ,, - � 63. �Heater & Vent�Final ` � � � � � . .�, �?� ... `;��r.; ,r . ' 13. Roof,Drains ' � - J' , � �� . � , , - � - .. ' i ! � , i - � . , i � ^ 64: Plumbing System-- Final � . , . .. �,, 14. Rough Plumbing�, � • ' . �''. � "�' - � � • 65. Electrical�Firial � .' ' : ' � , /(j� � j ± ' 15: ,Rough Electrical�Conduit - '� �.- - -�� � -, "� " 66. Solar�System-Final . "" � '" ` i ' - "" �� .� •; �.,16. •Rough Electric Wiring � ' : �� , * ,67. Fencing & Access A'pproval t"- „ +' " '- Z77.��:Rough Wiring Sign•' ^ • _ � ' ' 68. APPROVED FOR PLASTERING ' - _ - � _ � 18S Rough Electriral-T Bar Ceiling ' ., _ �. 69. POOUSPA SYSTEMS�FINAL � � - = � '' ° 19, Rough Heating & Air Conditioning � :� � • � , , ! FIRE DEPT.�REQUIREMENT' , - ` � , ' �* ' � ; e 20:��Rough Factory Fireplace ' '� ' ' � � . � APPROVALS Permit# ' � . ; „ ' " 21v Ducts,-in Siructure. � � , � � 70. Underground Hydro � ' � ' � � � � 1 ` � 22. Ducts/Ventilatin � � • � � . . ' 9 , � �77: Product Piping �Gas' OOiI ,`r- � ' '���23: Gas�Pipe-Rough & Test � ' - -�� ' �72: Underground Flush' . , ' ' 't � � �, �•24. Roof Framing � ' � • � �73.� Undergrnd.StoiageTank OGas'OOiI �� : � : ' � � 25. Roof Sheathing . . � � ' �74. Overhead Hydro .. - � I.` � , .26. T-Bar Ceiling (Structural) & Monocoat . • 75i Dry Chemical � - �� " ' _. � , !V"27. Frame and Flashing, - � � � � 76.� Dry Standpipe , , '' ' . � _ ' i ��28. :Lathing & Siding • . ' i � � � 7Z� FIXED SYSTEM FINAL � � � � � � . � � "� 29. ,Insulation � . � 78. FIRE PREV. FINAL � � � I - - 30. Drywall Nailing . �� ' , I • -HEACTH DEPT. REQUIREMENT , � '37. Plaster Brown Coat ' ' i� 79. FINAL INSPECTION � ' �32. Electrical Power Meter-Final �� � � � 80:� FOOD CERTIFICATE ISSUED . � ; v � 33. Final Electric � • , ' N tes: � � _�4 � � .; .•�ti � ,,.�,� 34. FinaPHeating &�Air Conditioning� . - � � '' I 4 <. � I �7 t.Y, ti✓ , f .i a� ��. �• ,. �,n.e�-��ss�?, 35. Final�Gas�Pipe-Test,' . ' ' � 'c� I'�, :� l.l. � :;� � � � ..o< � ...[�'_ %'1.;, . .r•- ' 36. Hood or Canopy ' . ' '' � ` - - " ' - ' /- ` � ` //�+ � 1 �` �%i�n.o n ih. � � � .�..�..�' �ll � 37. Fi'n'al Factory Fireplace , ; ' � ' , � � , � . ' - - 38. Final Plumbing . , � � - , r -- '. ` � � � - . � i 39. Water Service-Final t � ; � ' �� � � , ' ' � � ', - - . � • 40. Gas Se�vice-Final ! , � , � � � � � , ' " � ' " � '4 . � + . � � � i i 41. Solar pomesticFinal . , • ' � �j' ' � ' � •- ' ..Y" • - `. - '- ' - .. . l � 42. Baekflow`Preventer' i ' ; � � � `f .� , i �� � ,_ :> � `U - . � . �..�.._ .r : ' _ �. . ' ' ' - . .•t• , i � � 43. Backflow�lrrigation i .� � ; ',, ' � . ' i -'' �/ ' . � i :/' �� , � � . - . - . . . , i . .. - 44. ,Landscape Ir'rigation System ' �. � � � - i � � � � � � . - 45. Sound.Attenuation' . ' � � , ' � � � � --� � � y ; �� � 1f 1 ` 4 46. Handicap�Regulations-' , , . _ � . _ ` i z - i � t 1 � ' • ;1 47. FINAL STRUCTURE & BUILDING - .' � � � � I . � � i � - , , � � ` � � z ._ � � � " � 48. Special Requirements Completed �� ! =� � � � '` ( •- t , � � I ' ' ' , � � _ ` � �' ' " � ' � " 49. Electric Release to Edison � j � � �� � --�-�=• � i -t--^~� �i --� -•r--'� --�� ^f"^' �� - ; i ;! 'j ' ' � i� � , �y : i � , � ; _ . � � - � � - , � �- k-�.�, � � ,.-i 50. Gas Release to Southern California Gas Co � ! � !� i � i { � � � � ;a '' ,. t. � 51. CERTI FICATE OF.00CUPANCY : " j . _.�.�. L�!.-- '- � - -;_.- . _ � _ �_ I . _. �' �"->., � ' , ' � � � � : � j �' l , , ; ' � ' r, �, �b. . � „ •. .. � Date' �-. ��• . � � � � �: ...,.. -. ... - ' _ �a� > ._.< �w � '�. f_--:.J.... _ - . -_' ...+-' �'-.', - r•. _ .,..' • .��. � . , . . . '' Ph[D "� . •. ' ;�r i7—���<<a,F00 ��t�== -;—:,,�::?_2.64 � . - ��'-` 'COSTA MESA BUILDING-SAFETY DEPARTMENT � � , . . �� � � � � \` � . . ' � � P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 � ' , . y, . � - � .� P I ATION FOR BUILDING PERMIT a� �� � ' '�- For Applicant fo Fill in Completely \ , � RE 1 V DATE RECEIVED DATE I�SU7ED/ �\ � BUILDING ,// � `//%� ��. 7'/ / �� � �� �—� y' 1 ' ADDRESS 6l � � Q��ii/ JI�`O, ( .'N '. p J /� - � . OWNER 7��/;W1 . � . . A.P.NO.'I9 '1 �' ' � � — � P��� a v ' � ..MAtC ' . � ' . � .' 7 �. � AODRESS • .W ''. �j —j • -r � . Z . ADDRESS� ' 1 ' . W W . • ' ' ' ' • •• ' TEL. �. ' TRACT�'/� �S' LOT'a� BLOCK •. � d U CITV + .. . - NO. . .. . Z Q � CONSTRUCTION EW ADD A P O �, LENDER . . . . ' , , '. . 1 m � • • • J � BRANCH � " � ' J N •. ' � ' OWNEFi E LO m J ADDRESS ' . ' �p� AWE � m ARCHITECT � ' ' TEI.- I 1'tOOVE $ '�O " � J a . OR ENGINEER � N V Q.. , �/— , FIRE � a�/ w 2 � � ADORE55 . . .. , • .� . � � ZONE . . TVPE V -� GROUP' ' 'aw .. � ' . �yj�� � ' APPflOVED : . / % W Z CONTRACTOR �Ii(L��I� BV DATE �! —/ m � : . . . - ' . . . ' ' , . . • ' . ' • ° . _ Z . , •'J �' ' ADDRESS .� l. + . . :' . .• � .• . . .. � ' W W . . . ZONE ' ' NO OF � USE-bF NEW � ' "" ` � - ��= CITV . . ' . ,.NOL .�. PLAN$' BUILDING . v.�j e�r Z � , wO„ STATE ' , � �CITY,'!'"'.-:� . '.rARDSAPPROVED�• � YAADSAPPROVED {� � y¢' LICI'NO. ' ' ' -�IC.NO.-' �"'MAIN�BUICDING., ACCESSORVBUILOING � � SIZE . � � , � NO.OF.BLOGS. � .IFROM GL STREET) . . � �' OF LOT • . NOW ON LOT FRONT' FT. � '' ,� ' , �USEOF ' ' � ' � � ' . EXISTING B�OG. ' � ' � ' � � S F . FT � Z � NEW BLDG.�J' �/ ROOMS � � STORIES L. SIDE � + FT. ' � FT. � � a �EXTERIOR'WALL' - ROOF ' � � ' -�% COVERING� ' COVERING � -' REAR FT. " FT. J�- USE OF BUI�DING AND'WOFK TO BE PERFORMED � DISTANCE'BET. � • � � BET. MAIN &. "' � � a - ' MAIN BLDGS. . � ACCESS. BLOGS. - . a �, / a GL bL �-C�1'L/L . � �✓OLVC C VRP # � / APPRO, • . O� �� � .. APPAOVED ,L' � _ � y � p - HOLD FO SPE �(2E r U1 hereby acknowletlBa 2het I haJe reatl Mis aDPlicetion:anE state � �, � that the above intormation is col�eci en0 aB�ee �to tomply with � � ' all laws regulaUng building consbucxion; entl-I sh611 not amploy . '�. � , F any parson in �violatio� ot Me workman's compensation laws of - � me s<eca ot ceuto��ia.:� '''� �-. �� r2 m SQ. FT. � , Z I hereby, cartify that I am"properly licensetl as a contrector unCer . ��- � - � � the State ot Californie Business an0 Professions CoEe,�Divisicn 3, THE AMOUNT SHpWN NDER VALUATION IS FOR � . Chaptar 9, antl that such licenses ara in full torce'antl affeci, or I THE PURPOSE OF ESTA ISHING A PERMIT FEE ONLV: m ' am exempt trom the prov(zions ot the State ot Calitornia Businass � ¢ antl Professions Coua,'Division 3, Chaptpr 9. " VALVATION ,. � n �,� � // ' n� • o-� � ERMIT FEE $ . . � ' � Sienature Of \// // Q /� . . - Q-7/ m Parmittee Pi i)17� FL $ I'[ Qp P CHECK $' �� E. � . „ o . Authorized Agant ' ' ' LL TOTAL FEE $ ...y.� . _ � �` �84�,8- � . � COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely BUILDING /�_� � „ . 10't,d ��' ADDRESS P Y� 0 OWNER �� 1�<TC �O�`C��S . ADDRESS �O� � 1"k� S'� /)_S�A �CSQ TEL. GITV L-(J NO. CAN5TRUCTION LENDER S�F4ME BRANCH F ADDRESS ARCHITECT SA�E TEL � , OR ENG7MEER N ADDRESS � CONTRACTOR / ADDRESS TEL. CITV NO. STATE CITV LIC. NO. LIC. NO. SIZE NO. pF BLDGS. OF LOT NOW ON LOT USE OF � EXISTING BLDG. SI2E OF NO. OF NEW BLDG. a� ROOMS STORIES EXTERIOR WALL ROOF COVERING COVERING USE OF BUILDING AND WORK TO BE PERFORMED J)-'f-f _ ! _/�tI �. �-Lii/ �s �N FOR BUILDING PERMIT DATE FECEIVED DATE IS�SUI � i �� BUILDING ADDRESS OWNE FIRE ZONE APPROVED ZONE NO.OF � PLANS VARDS APPROVED VAfl. :K+ C.U.P.,aW APPqf NEO I hareby acknowletlge that I have rAatl this applicetion antl stete that ihe above intormetion is correct antl agree to comply with �- ell laws regulatine building consvuction, antl I shall not employ any person in violation of the workman's compensation lewc of _ the State ot California. - I hereby cartify ihat I am p�operly licensed as e contractor under Ma State of Californie Business and Professions Cotle, Divisicn 3, 7 Chaptar 9, and that such licenses are In full force and effect, or I T am ex0mpt from the provisions of the $tate ot CalifOrnie Businass antl Protessions C Division 3, Chapter 9. up'� ♦ Sipnatura of . � � � e Pe�mittee $ a Authorized ABent 8 USE OF NEW' ��—�� BUIIDING VAflDSAPPROVED BET. MAIN & . ACCESS. BLDGS �ATE �J . m D� SQ. FT. AMOUNT SHOWN UNDER VALUATION �S FOR ' PVRPOSE OF ESTABLISHING A PERMIT FEE ONLY: Q TION O�� � ' rq PERMIT FEE $ m _ � � � � PLAN CHECK $ E �d /�"�/ � `o LL